CU 40. Cystic Wilms' tumor in an adult

A 26-year-old man with abdominal distention and fever for 6 months was found to have a huge cystic mass in the right retroperitoneal space, which was confirmed by Computer Tomography(CT) and had close relationship with right kidney. A radical resection of the tumor was performed and Wilms' tumor was confirmed by pathological assay.

A 26-year-old man with continuous abdominal distention and fever for more than 6 months, and the maximum body temperature was 38.8 centigrade degree. The patient had the history of renal calculi for 4 years, and sclerosing agent injection treatment for renal cyst 5 years ago. A high tension cystic tumor could be palpated in the right upper region of abdomen. Computer Tomography showed a lesion located in the retroperitoneal space, and had close relationship with kidney and psoas muscle. It was misdiagnosed to be recurrent renal cyst and hydronephrosis initially in other institutes, so the patient received ureteral stent insertion of right ureter and percutaneous puncture and drainage of the cystic mass, which were not effective. The patient underwent a surgical procedure. During the operation, it was found that a partial cystic and partial solid mass derived from right kidney, which almost took over all room of the right retroperitoneal space. The tumor was removed radically, and the final pathological evaluation showed a Wilms' tumor. Wilms' tumor is one of the most common malignant solid tumor of infant, most being diagnosed in the first 5 years of the life, but it is extremely rare in adults. In adults, it has a poorer prognosis than in children even for the same stage. Currently, most studies recommend combining treatment of operation, chemotherapy and radiotherapy. But due to the rarity of the lesion, a standard treatment for this disease has not been well established.